February 29, 2004

LAST Monday, the front page report of a Malay daily screamed accusations of delay and tardiness at the Health Ministry. Parents of children requiring medical assistance slammed Health Minister Datuk Chua Jui Meng’s earlier statement denying red tape in the disbursement of financial aid from the National Health Welfare Fund.

“There is no logic to his statement,’’ Abdul Halim Othman, a 37-year-old father, told the daily. “He is merely defending the bureaucracy in his ministry. Ask him to come to the ground to see for himself.”

The report was followed by a television poll in which a majority of viewers criticised the ministry.

The minister, at a Press conference last Wednesday, accused the daily of having a hidden agenda for its distorted report.

Holding up Halim’s “thank you’’ card, he said: “I cannot imagine why a person who sent us such a heart warming message should now turn around and accuse us of being so callous.

“I personally oversee these applications and I would know if my officers have been tardy. They were not. And as minister, I will defend my officers if they are wrongly accused.”

The National Health Welfare Fund (NHWF) was set up following public controversy over the RM350,000 collected for TV personality Ras Adiba Radzi and the death of baby Sofea Qhairunnissa Ali while awaiting a liver transplant.

It was on Sept 4, 2002, that the Cabinet announced the setting up of the NHWF with the directive that patients seeking public dona-tions for treatment must first have their cases evaluated by the Director-General of Health.

The Cabinet also directed organisations to stop collecting public donations until the case was assessed through proper channels and deemed necessary following the increasing number of inquiries and complaints from the public and the medical fraternity on the validity of requests made through the media.

“Malaysians are a very generous lot, and we do not want this to be abused,” said Chua. “That is why we want to ensure that there is transparency and accountability.’’

Under NHWF, patients who approach the media or other organisations must furnish medical documents and reports to these organisations and they, in turn, must submit these documents to Health Ministry Director-General Tan Sri Dr Mohamad Taha Arif and his committee who will evaluate each case.

“The D-G will make inquiries before deciding if the case can be treated at government hospitals, which are heavily subsidised and committed to treating those from the lower income group. He would also decide, after discussions with the relevant specialists and hospitals, on the best form of treatment. This could be either conservative treatment or surgery.’’

Once it is ascertained the treatment cannot be done in a government hospital but in a private hospital either at home or abroad, only then will the mass media or other organisations be allowed to go ahead with fundraising.

The D-G will also determine through discussions which private hospital will provide the treatment at the appropriate cost. Funds collected from the public must be channelled to the NHWF to finance the medical expenses.

“All monies will be paid directly to the hospital and health provider, and any balance will be kept for other cases.”

The Cabinet approved a RM5 million contribution to the fund. Chua said the vetting of applications was done on a “fast-track basis” by the NHWF committee.

On delays in processing some applications, Chua said: “It happens when applications are incomplete and the applicant does not give his contact number. The delay occurs when the committee has to track down the applicant to get more details or when no specialists’ reports were attached.’’

All applicants were interviewed to ascertain their background before applications are approved, said Chua.

“We try to expedite the processing of all applications and it is sad when, in spite of all the effort taken, accusations and criticisms are hurled at the ministry.”

He said there were times when the commit-tee went out of its way to help people whose plight was highlighted in the media, even though they did not put in their applications.

Chua said he had briefed the Cabinet and it had accepted his explanation.

“I also told the Cabinet that I believe there is a hidden agenda that needs to be investigated.”

On Wednesday, Chua gave a detailed account of all the four cases the newspaper had high-lighted. He said he hoped the public would understand what had actually transpired.

The minister also said the ministry was working on developing its own liver transplant centre at the Selayang Hospital.

He said Malaysia had excellent medical services and many specialists capable of con-ducting major transplant surgery of hearts, livers and kidneys.

“In Selayang Hospital alone, we have nine liver specialists. Why go to private hospitals when, in government hospitals, patients in a third class ward can undergo major transplants for a minimum fee of RM500?’’

February 28, 2004

A seminar on Enhancing Cooperation in the Medical and Healthcare Services between Malaysia and Negara Brunei Darussalam was held at the Mutiara Ballroom of Sheraton Utama Hotel yesterday morning.

To officiate the auspicious event, the High Commissioner of Malaysia to Brunei Darussalam, Tan Sri Mohd Jamil Johari in opening remarks said that last year, Malaysia gained RM85 million from overseas patients who came to Malaysia seeking treatment for various diseases.

He said Brunei and Malaysia share a common ground in terms of stability and security. He felt that these last few years, tremendous changes had occurred in social welfare and provision of medical and health services in both Brunei and Malaysia.

According to him, both countries possess world-class medical and health facilities and although there are some countries leading in other specialised medical field, Brunei and Malaysia are not far behind. Through this seminar, he hoped that people would be aware of the medical facilities and services available in both countries which may lead to further cooperation in personnel training and exchange of ideas in any medical field.

More than 30 people from Brunei’s Ministry of Health and prominent health companies attended the seminar. The seminar ended with a business meeting between interested private and public organisations of both countries.

CIPLA Ltd expects to ship its consignment of anti-AIDS drugs or anti-retrovirals (ARV) to Malaysia in a couple of months, the Joint Managing Director of Cipla, Mr Amar Lulla, told Business Line.

This follows the issuance of a compulsory licence by the Malaysian Government for the supply of ARVs to Government-run or public hospitals in Malaysia.

The ARVs that Cipla will be exporting are generic or chemically-equivalent versions of Didanosine 100 mg and 25 mg tablets, produced originally by Bristol-Myers Squibb (BMS) and Zidovudine 100 mg capsule and the combination drug Lamivudine 150 mg + Zidovudine 300 mg tablet — both from GlaxoSmithKline (GSK).

Unwilling to divulge the size of the order, Mr Lulla said that it was a “significant” order. But, the royalty to be paid to the original patent-holders of these drugs, i.e. BMS and GSK, is yet to be worked out.

“The payment of compensation shall be made to the patent holder(s) within two months of each import of the said drugs. The rate of compensation is to be determined at a later date,” industry sources familiar with the development said.

However, Mr Lulla said that the royalty issue would be taken care of by the Malaysian Government and it would not stop Cipla from going ahead with its supplies. The authorisation is valid for two years, commencing November 2003, and analysts said that Cipla’s execution of the order would be closely watched by other countries and companies.

“If the royalty issue is resolved and Cipla is able to supply soon enough, then more countries would be encouraged to adopt similar measures. It is possibly the first compulsory licence issued by any Government after the August 30, 2003, decision on Para 6 and it could provide an interesting test case to assess whether the decision is workable or needs modification,” observe industry analysts.

Trade negotiations last year had allowed countries to issue compulsory licenses in the event of public health emergencies and the onus was on local governments to decide what was a health emergency that was serious enough to invoke a compulsory licence.

A compulsory licence allows a country to over-ride an existing drug patent and get other companies to supply the same drug at a cost decided upon by the Government. A royalty payment was to be made to the innovator company, whose patent would be “broken” when a compulsory licence was issued.

However, the issue has always generated debate, since generic companies felt that governments would use it to haggle over price. Multinational pharma companies felt that the triggers for governments to issue a compulsory licence were too low and that generic companies would, in fact, divert the drugs into other high-margin markets.

Trade bodies had tried to address some of these issues by asking generic companies to package their drugs and colour them differently, so that they could not be sold in the open market or diverted to other regions.

And while Cipla may have undertaken a similar order to Nigeria in 2001, the present order generates interest also because it comes at a time when the Indian Government is trying to get its act together on working out similar procurements to supply ARVs to HIV/AIDS patients in the country, observe analysts.

Gopal said he had paid RM2,120 in cash for his card and was told he would receive his card within 30 days.

“But until today, I have not seen it,” he said, adding that queries to the agent had been futile.

He claimed that he had tried to call the Kop MediCare headquarters in Bandar Puchong Utama but was given the run-around as his calls were never put through to anyone in authority.

Frustrated, Gopal sought the help of friends in Kuala Lumpur to check out the office.

Fed up with the way things were going, Gopal said he approached the agent again and asked for a refund as he wanted to cancel his purchase “The agent asked for all the documents and I obliged but until today, I have not got a single sen back,” he said.

Forty-four patients suffering from chronic illnesses have benefited from the National Health Welfare Fund, Health Minister Datuk Chua Jui Meng said today.
Refuting allegations that bureaucracy had delayed disbursement from the fund, he said, the ministry had dealt with 321 cases — almost one a day — since the fund was launched in September 2002.

Chua said RM1.5 million was disbursed to the 44 patients for treatment in government or private hospitals as well as overseas.

“Another 277 applicants who also sought financial assistance from the NHWF were referred to government hospitals,” he said when commenting on reports in a Bahasa Malaysia daily that the ministry had failed to fulfil its objective of helping the lowincome group.

Chua said another 35 cases, each seeking a sum of between RM40,000 and RM80,000 for chronic illnesses, were pending approval.

“All applications sent to the fund are vetted immediately by the NHWF committee headed by Director-General of Health Tan Sri Dr Mohamad Taha Arif. If applicants deserve the aid, approval is given without undue delay.” Chua gave a detailed account on each of the four cases highlighted in the newspaper.

He also said he had asked the Cabinet to waive some of the stringent conditions for applicants of the Chronic Disease Special Fund, which is different from the NHWF.

This includes the condition that only people with income less than RM600 can benefit from it and that they must raise a dollar for every dollar given by the ministry.

February 26, 2004

UTUSAN Malaysia and Health Minister Datuk Chua Jui Meng have been engaged in a battle of words in the past few days over the distribution of financial aid to chronic patients.

It began with the paper carrying Chua’s statement denying that bureaucracy was causing problems in the distribution of aid from the RM5.4mil National Health Welfare Fund and the RM100mil Special Chronic Diseases Fund.

The paper then carried a report the following day disputing Chua’s statement, quoting parents of patients with liver diseases who had encountered many problems in applying for the aid.

It said Abdul Halim Othman, 37, whose 15-month-old son Aliff Hambali suffers from the disease, had to make follow-up calls almost daily for nearly a month to the ministry to check the status of his application.

Abdul Halim had said that the secretariat would always tell him that his application was incomplete before finally telling him that he was not eligible for the fund since he was a civil servant.

It also said that Mohd Ezani Yaacob, whose daughter Nurnesa Uzma suffers from a critical liver disease, faced problems in submitting his application since the doctors and staff of the Kuala Terengganu hospital did not know the procedure of applying for the aid.

The paper said that despite Mohd Ezani having submitted the forms personally and having been given an acknowledgement slip, the secretariat told Mohd Ezani on Jan 19 that they had not received his application.

In a Bernama report carried by the paper yesterday, Chua said that his statement was misconstrued.

“Utusan Malaysia has an agenda because it keeps raising untrue reports like this. This is not responsible journalism,” the report quoted Chua as saying.

Chua said it was the paper and not the patients’ parents who criticised the Health Minister, adding that in his meeting with the paper in Muar, he did not comment on alleged problems caused by red tape in the aid distribution to chronic patients at all.

He also said that the paper did not give a true picture of the situation to the public and portrayed the ministry as cold towards the plight of the public.

“The ministry takes care of 50 million patients each year at its hospitals and clinics while charging the lowest cost in the world and giving high quality professional service,” said Chua.

He, however, admitted that there was a delay in Nurnesa Uzma’s case and it was being investigated.

February 25, 2004

Landmarks Bhd’s healthcare units MediScreen Sdn Bhd and Qualitas Medical Group Sdn Bhd have inked an agreement with an Indonesian group to provide medical screening services for Malaysia-bound Indonesian workers.

Under a memorandum of understanding with Indonesian Manpower Services Association (APJATI), MediScreen and Qualitas will bring its medical expertise in the health screening of foreign workers in Malaysia to the republic.

Indonesian workers in Malaysia would also benefit from preferential rates for medical check-ups and treatments at both the MediScreen and Qualitas panel of clinics and hospitals, Landmarks managing director M.A. Halim Ahmad said.

Speaking to reporters yesterday after the signing ceremony in Kuala Lumpur, Halim said it was still too early to give a projected revenue from the venture.

Najib was asked to comment on a news report in a Malay daily on complaints by the family of a patient suffering from biliaryatresia that they had difficulties dealing with the Health Ministry to get financial aid.

They were reported to have criticised Chua for his statement that there was no red tape involved in the distribution of aid to chronic patients.

In Kuala Lumpur, Chua criticised the paper for distorting his statement.

“The patient’s parents did not criticise the Health Minister. It is this newspaper which has,” he told reporters on the sidelines of the China-Malaysia Economic conference here. – Bernama

February 24, 2004

PROF Victor K. E. Lim (pic) has been appointed Dean of the International Medical University’s Faculty of Medicine, from Feb 1. He is also Professor of Pathology.

Prior to this appointment, Prof Lim was director of the Infectious Diseases Research Centre at the Institute for Medical Research, having been seconded to the Health Ministry from Universiti Kebangsaan Malaysia (UKM).

His impressive career in the field of medicine began in 1974 when he obtained his MBBS from Universiti Malaya, before getting an MSc in Medical Microbiology (with distinction) at the University of London in 1978. Three years later he was admitted to the Royal College of Pathologists in 1981.

Joining UKM’s Faculty of Medicine in 1976, Prof Lim was made an associate professor in 1982 and a full professor in 1989. During his tenure with the medical faculty, he was head of the Department of Medical Microbiology and Immunology and deputy dean for academic affairs.

He is at present president-elect of the Western Pacific Society of Chemotherapy and scribe of the Academy of Medicine of Malaysia. Prof Lim has also been president of the Malaysian Society for Infectious Diseases and Chemotherapy. He became a fellow of the Royal College of Pathologists in 1992 and a founding fellow of the Academy of Medicine in 1996.

IMU president Tan Sri Dr Abu Bakar Suleiman said that he is confident that Prof Lim will contribute to the growth of IMU. “His experience as Professor of Microbiology and as deputy dean in UKM coupled with his leadership at professional societies at the international level will bring strength to IMU. Prof Victor’s standing as an expert on infection control and anti-microbial chemotherapy in international circles will contribute to research in these fields,” he said.